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Clinicopathologic analysis of intraductal papillary neoplasm of bile duct: Korean multicenter cohort study.
HPB ( IF 2.9 ) Pub Date : 2019-12-11 , DOI: 10.1016/j.hpb.2019.11.007
Jae Ri Kim 1 , Kee-Taek Jang 2 , Jin-Young Jang 1 , Kyungbun Lee 3 , Jung Hoon Kim 4 , Haeryoung Kim 5 , Sun-Whe Kim 1 , Wooil Kwon 1 , Dong Wook Choi 6 , JinSeok Heo 6 , In Woong Han 6 , Shin Hwang 7 , Wan-Joon Kim 7 , Seung-Mo Hong 8 , Dong-Sik Kim 9 , Young-Dong Yu 9 , Joo Young Kim 10 , Yang Won Nah 11 , Hyung Woo Park 11 , Hye-Jeong Choi 12 , Ho-Seong Han 13 , Yoo-Seok Yoon 13 , Sang Jae Park 14 , Eun Kyung Hong 15 , Hyung Il Seo 16 , Do Youn Park 17 , Koo Jeong Kang 18 , Yu Na Kang 19 , Hee Chul Yu 20 , Woo Sung Moon 21 , Chang-Sup Lim 22 , Jeong Mo Bae 23 , Sungho Jo 24 , Wonae Lee 25 , Young Hun Roh 26 , Jin Sook Jeong 27 , Chi-Young Jeong 28 , Jong Sil Lee 29 , In-Sang Song 30 , Kyung-Hee Kim 31 , Ho Gak Kim 32 , Chang Ho Cho 33 , Sun-Hyung Joo 34 , Kyu Yeoun Won 35 , Hong Jin Kim 36 , Joon Hyuk Choi 37 , Chong-Woo Chu 38 , Jung Hee Lee 39 , Il Young Park 40 , Heejeong Lee 41 , Seung Eun Lee 42 , Hee Sung Kim 43 , Hyeon Kook Lee 44 , Min-Sun Cho 45 , Hongbeom Kim 46 , Kang Min Han 47
Affiliation  

Background

IPNB is very rare disease and most previous studies on IPNB were case series with a small number due to low incidence. The aim of this study is to validate previously known clinicopathologic features of intraductal papillary neoplasm of bile duct (IPNB) based on the first largest multicenter cohort.

Methods

Among 587 patients previously diagnosed with IPNB and similar diseases from each center in Korea, 387 were included in this study after central pathologic review. We also reviewed all preoperative image data.

Results

Of 387 patients, 176 (45.5%) had invasive carcinoma and 21 (6.0%) lymph node metastasis. The 5-year overall survival was 80.9% for all patients, 88.8% for IPNB with mucosal dysplasia, and 70.5% for IPNB with invasive carcinoma. According to the “Jang & Kim's modified anatomical classification,” 265 (68.5%) were intrahepatic, 103 (26.6%) extrahepatic, and 16 (4.1%) diffuse type. Multivariate analysis revealed that tumor invasiveness was a unique predictor for survival analysis. (p = 0.047 [hazard ratio = 2.116, 95% confidence interval 1.010–4.433]).

Conclusions

This is the first Korean multicenter study on IPNB through central pathologic and radiologic review process. Although IPNB showed good long-term prognosis, relatively aggressive features were also found in invasive carcinoma and extrahepatic/diffuse type.



中文翻译:

胆管导管内乳头状肿瘤的临床病理分析:韩国多中心队列研究。

背景

IPNB 是一种非常罕见的疾病,以往关于 IPNB 的研究大多是病例系列,由于发病率低,病例数较少。本研究的目的是基于第一个最大的多中心队列验证胆管内乳头状肿瘤 (IPNB) 先前已知的临床病理特征。

方法

在韩国每个中心先前诊断为 IPNB 和类似疾病的 587 名患者中,387 名在经过中心病理学审查后被纳入本研究。我们还审查了所有术前影像数据。

结果

在 387 名患者中,176 名 (45.5%) 患有浸润性癌和 21 名 (6.0%) 淋巴结转移。所有患者的 5 年总生存率为 80.9%,伴黏膜发育不良的 IPNB 为 88.8%,伴浸润性癌的 IPNB 为 70.5%。根据“Jang & Kim 改良解剖学分类”,肝内型 265 例(68.5%),肝外型 103 例(26.6%),弥漫型 16 例(4.1%)。多变量分析显示,肿瘤侵袭性是生存分析的独特预测因子。(p  = 0.047 [风险比 = 2.116,95% 置信区间 1.010–4.433])。

结论

这是韩国第一项通过中央病理和放射学审查过程对 IPNB 进行的多中心研究。尽管 IPNB 显示出良好的长期预后,但在浸润性癌和肝外/弥漫型中也发现了相对侵袭性的特征。

更新日期:2019-12-11
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